一人大醉饮水与冷茶无数后病便血甚鲜先以吴茱萸丸翌日又与平胃五苓散各半三大服血
止复
变白痢又与神应丸四服白痢乃止安和如故或问曰何不用寒凉解毒所用者温热之剂医曰君用寒
凉药其疾大变难疗寒毒内伤复用凉药非其治也况血为寒所凝侵入大肠间而滞下作痛得温乃行
所以用温热其血自止经曰治病必求其本此之谓也(医垒元戎)
吾邑陆炳文本富家子年三十岁时七月间患血痢日夜百余度肚腹 痛医悉用芩连阿胶粟壳
之剂
皆不效其病反剧家人惊怖邀老医刘宗序脉之曰脾胃受伤苦用寒凉病安得愈投以四君子汤加干
姜附子其夕病减半旬日而愈或问其故刘曰病者夏月食冰水瓜果太多致令脾家伤冷血不行于四
肢八脉渗入肠胃间而下吾所用附子干姜补中有发散其所伤冷毒故得愈也王汝言杂着有云芩连
芍药为痢疾必用之岂其然乎
宋孝宗尝患痢众医不效德寿忧之过青宫偶见小药肆遣使问之能治痢否对曰专科遂宜之至
请得
病之由语以食胡蟹多故致此疾遂令诊脉曰此冷痢也遂进一方用莲藕一味不拘多寡取新采者为
佳细捣汁以热酒调服捣时用金杵臼酒调数次而愈德寿大喜就以金杵臼赐之仍命医以官至今呼
为金杵臼严防御家可谓不世之遇(仇远稗史)
仲景治痢法可下者十法可温者五法谓之下者率用承气汤加减谓之温者率用姜附汤何尝以
巴豆
粟壳之剂乎俗医见自利而渴烦躁不眠手足微冷者皆用苦剂攻之殊不知阴盛发燥欲坐井中故前
哲用吴茱萸汤甚者用四逆汤经曰阳虚阴乘之谓也丹溪用吴茱萸汤治霍乱吐泻转筋者亦此意也
近时医人不审痢之赤白病之新久骤用罂粟壳石榴皮之类以为秘方其功但施于久痢洞泄者则
宜
若初起者用之闭塞积滞变生别症以致经年累月谓之体息痢者是也世俗但知涩剂之能塞不知通
剂之能塞也后之学人贵在变通不可执一而治
有一位男子大醉后饮用了无数的水和冷茶，随后患病出现便血，血色非常鲜红。起初使用吴茱萸丸，第二天又给予平胃散和五苓散各半剂，共三大服，血止住了，但病情转变为白痢。接着又服用神应丸四次，白痢才停止，身体恢复安和如常。有人问：“为什么不用寒凉解毒的药物？所用的是温热之剂。”医生回答说：“如果您用寒凉药，病情会发生剧烈变化而难以治疗。寒毒内伤，如果再复用凉药，就不是正确的治疗方法了。况且血液被寒气凝滞，侵入大肠之间，导致下痢腹痛，得到温热才能运行，所以使用温热药物，血液自然停止。《内经》说：治病必求其本，说的就是这个道理。（出自《医垒元戎》）
我们县陆炳文，是富裕人家的子弟，三十岁时，七月间患血痢，日夜拉一百多次，腹部疼痛。医生们都用黄芩、黄连、阿胶、粟壳等药物治疗，都不见效，病情反而加重。家人惊恐害怕，邀请老医生刘宗序诊脉。刘医生说：“脾胃受伤，苦于滥用寒凉药，病怎么能好？”于是投以四君子汤加干姜、附子。当晚病情减半，十天痊愈。有人问他缘故，刘医生说：“病人在夏天吃了太多的冰水、瓜果，导致脾脏受寒，血液不能运行于四肢八脉，渗入肠胃之间而下泄。我用的附子、干姜具有补益中兼有发散的作用，能够驱散所受的寒毒，所以痊愈。王汝言在杂著中说黄芩、黄连、芍药是治痢疾必用的药，难道真是这样吗？”
宋孝宗曾经患痢疾，众医治疗效果不佳，德寿宫为此忧虑。路过青宫时，偶然看到一个小药店，派人去问能否治疗痢疾。对方回答说是专科医生，于是被请入宫中。询问得知病因是因为吃螃蟹太多导致此疾。于是让医生诊脉，医生说这是冷痢。于是开一方，只用莲藕一味药，不限多少，以新采的为佳，细细捣汁，用热酒调服。捣药时用金杵臼，酒调服几次后痊愈。德寿大喜，就把金杵臼赐给他，并命令医生担任官职至今，人们至今仍称之为“金杵臼”严防御家，这真是不世之遇。（出自仇远《稗史》）
张仲景治疗痢疾的方法，可下的有十法，可温的有五法。所谓“下者”，通常使用承气汤加减；所谓“温者”，通常使用姜附汤。何曾使用过巴豆、粟壳之类的药剂呢？世俗医生见到自利（腹泻）、口渴、烦躁不眠、手足微冷的人，都用苦寒药剂攻伐，却不知道这是阴盛发燥，想要坐在井中降温，所以前代哲人使用吴茱萸汤，严重的甚至使用四逆汤。《内经》说：阳虚阴乘，叫做这个意思。丹溪用吴茱萸汤治疗霍乱吐泻转筋，也是这个意思。近时的医生不审察痢疾赤白、病程新久，骤然使用罂粟壳、石榴皮之类作为秘方，其功效只适用于久痢洞泄者则适宜。如果是初起者使用，会闭塞积滞，变生其他病症，以致经年累月，称为体息痢。世俗只知道涩剂能堵塞，不知道通剂也能堵塞。后来的学人贵在变通，不可固执一端而治疗。
A man, after drinking heavily and consuming countless amounts of water and cold tea, fell ill with bright red blood in his stool. Initially, he was treated with Wuzhuyu Wan (Evodia Pill). The next day, he was given Pingwei San (Powder to Maintain the Stomach) and Wuling San (Five-Ingredient Powder with Poria) in equal halves, administered as three large doses. The bleeding stopped, but the condition transformed into white dysentery. He was then given Shenyin Wan (Miraculous Response Pill) four times, after which the white dysentery ceased, and he returned to a state of peace and health. Someone asked, "Why were no cooling and detoxifying medicines used? Why were warming agents employed?" The physician replied, "If you had used cooling medicines, the disease would have changed drastically and become difficult to treat. Cold-toxin injuring the interior, followed by the use of cold medicines, is not the correct treatment. Moreover, blood coagulated by cold invades the intestines and colon, causing tenesmus and pain; it moves only when warmed. Therefore, warming medicines were used, and the bleeding stopped naturally. The *Classic* states: 'In treating diseases, one must seek the root.' This is what is meant." (From *Yilei Yuanrong*)
Lu Bingwen from our county was the son of a wealthy family. At the age of thirty, in July, he suffered from bloody dysentery, defecating over a hundred times a day and night, accompanied by abdominal pain. Physicians all prescribed Huangqin (Scutellariae Radix), Huanglian (Coptidis Rhizoma), Ejiao (Donkey-hide Gelatin), and Yingkesu (Papaveris Pericarpium) without effect, and his condition worsened. His family, terrified, invited the elderly physician Liu Zongxu to take his pulse. Liu said, "The spleen and stomach are injured; suffering from the abuse of cold medicines, how can the disease heal?" He prescribed Sijunzi Tang (Decoction of Four Gentlemen) with Ganjiang (Zingiberis Rhizoma) and Fuzi (Aconiti Lateralis Radix Praeparata). That evening, the illness halved, and within ten days, he recovered. When asked for the reason, Liu said, "The patient consumed too much ice water and melons/fruits in summer, injuring the spleen with cold. Blood failed to circulate through the four limbs and eight vessels, seeping into the intestines and colon and flowing downward. My use of Fuzi and Ganjiang provides tonification with dispersing properties, dispelling the injured cold-toxin, hence the recovery. Wang Ruyan wrote in his miscellaneous notes that Huangqin, Huanglian, and Shaoyao (Paeoniae Radix Alba) are essential for dysentery. Is this really so?"
Emperor Xiaozong of Song once suffered from dysentery. Many physicians failed to cure him, causing anxiety at the Deshou Palace. Passing by the Qinggong, he happened to see a small medicine shop and sent an envoy to ask if they could treat dysentery. The reply was that it was their specialty, so he was summoned. Upon learning the cause was excessive consumption of crabs, the physician diagnosed it as cold dysentery. He prescribed a formula consisting solely of Oujié (Lotus Rhizome), regardless of quantity, preferring freshly harvested ones. It was finely crushed to extract juice, mixed with hot wine for administration. A golden mortar and pestle were used for crushing. After several doses mixed with wine, he recovered. Deshou was overjoyed and bestowed the golden mortar and pestle upon him, also appointing the physician to an official post. To this day, people still refer to the Yan Fangyu household as having received this rare honor. (From Qiu Yuan's *Baishe*)
Zhang Zhongjing’s methods for treating dysentery include ten purgative methods and five warming methods. The "purgatives" generally involve modifications of Chengqi Tang (Major Order the Qi Decoction); the "warmers" generally involve Jiangfu Tang (Decoction of Ginger and Aconite). Where did the use of Badou (Crotonis Fructus) or Yingkesu come from? Common physicians, seeing patients with spontaneous diarrhea, thirst, irritability, insomnia, and slightly cold hands and feet, all use bitter-cold purgatives. They do not realize this is dryness caused by excess Yin, where the patient desires to sit in a well to cool down. Thus, ancient sages used Wuzhuyu Tang (Evodia Decoction), and in severe cases, Sini Tang (Frigid Extremities Decoction). The *Classic* states: "Yang deficiency with Yin encroachment." Danxi used Wuzhuyu Tang to treat Huoluan (Cholera-like syndrome) with vomiting, diarrhea, and muscle twitching, applying the same principle. Recent physicians, failing to examine whether the dysentery is red or white, or whether the disease is new or chronic, rashly use Yingkesu (Papaveris Pericarpium) and Shiliupi (Punicae Cortex) as secret formulas. Their efficacy is suitable only for chronic dysentery with profuse discharge. If used in early stages, they obstruct stagnation, leading to other complications, resulting in a condition lasting years, known as Tixi Li (Stagnant Dysentery). The lay public only knows that astringents can block, but do not understand that unblocking agents can also block. Future students should value flexibility and not adhere rigidly to a single approach.